chapter 2 Flashcards
TBI
traumatically induced psychological disruption of the brain structure and function resulting from the application of a biomedical force to the head, rapid acceleration and/or deceleration or blast-related forces
incidence
500,000 new cases of tbi per year
prevalence
200 cases per 100,000 people in the US
intentional accidents
incidents where a person know that they will be at some risk of sustaining a TBI
-assaults, DV, child abuse, sporting accidents
-may not be as willing to seek help
non-intentional accidents
accidental in nature and people are more likely to seek help during such incidents
-road accidents, falls
open head injuries
a sharp object penetrates the skull and enters the brain
low velocity open
injuries are typically assoc. with objects travelling at low velocity
-stabbing, axe, hit by branch
high velocity open
assoc with relatively higher velocity travelling objects
-gun shot wound
closed head injuries
no actual insertion of a foreign body into the cranium
-MVA, skiing accidents, sports-related events
non-acceleration closed
a person at rest being hit by another moving or stationary object/person
acceleration closed
a person in motion hit by another moving or stationary object/person
diffuse axonal injury closed
during most acceleration injuries there is a possibility of severe neuronal damage where axons may be damaged, stretched, or torn
lumbar puncture
diagnostic procedure for measuring CSF in order to assess the possibility of hydrocephalus
immediate brain changes after brain injury
changes that occur at the onset of the tbi
-inflammation, bleeding, loss of consciousness, fractures
secondary brain changes
changes noticed minutes, hours, days, or weeks following TBI
-headaches, loss of attention and sensation, pain
hypoxia
reduced levels of oxygen
anoxia
complete absence of oxygen
shaken baby syndrome
violent shaking of infant or young child leading to brain damage
-may lead to brain swelling, intracranial bleeding, diffuse axonal injuries, retinal hemorrhages
gender
men are twice more likely to experience tbis than women 4:1
age
teens and young adults 15-24 years old
causes of tbi**
children: falls
adolescents: sporting an MVA
elderly adults: falls
moderate and severe tbi causes
MVA across all age groups
substance abuse
drug and alcohol use increases the risk for tbi
1999: 42% of brain injury survivors were heavy drinkers
prior history of tbi
general risk is 20% for men and 8% for women
chance for 2nd tbi is _____ times as likely, a 3rd tbi is ______ times as likely
3x, 8x
medical conditions
co-occurrence of cardiac disorders and tbis lead to possible inadequacies in the blood supply of the brain and this interrupts in the consciousness level or physical functioning
extent and location of damage
diffuse damage has a poor prognosis to focal damage
-area of damage can influence recovery: damage in and around the perisylvian cortex has poor outcomes compared to other non-language dominating areas
-severity ranges from mild concussions to severe disability or even death
coma
a period of unconsciousness or unawareness following a brain injury
-GCS: used to monitor changes in the level of consciousness: 3 is lowest possible score
-Galveston orientation and amnesia test: assess major features of functioning along with post-traumatic amnesia (PTA)
recovery from coma may lead to
a vegetative state, a minimally conscious state, or locked-in syndrome
post-traumatic amnesia
period beginning from onset of TBI (including coma) and extends till the persons memory for ongoing events become reliable, consistent, and accurate
-duration correlates with residual physical and cognitive impairments as well as independent, possibility of returning to pre-morbid functioning levels
minimally vegetative state
-intact autonomic functions (heartbeat, thermoregulation), and sleep-wave cycle with absence of awareness
-these patients can open their eyes spontaneously or in response to stimulation by only showing reflexive behaviors that are unrelated to the environment
minimally concious state
patients are aroused and show fluctuating and reproducible signs of awareness
-demonstrate orientation to behavioral and emotional responses (following directions, visual pursuit, and response to smell)
genetic predisposition
presence of ApoE gene leads to greater risk of developing AdDementia and the current research indicates mixed feelings
